1. Field of Invention
This invention relates to a unique patient retention and support assembly particularly designed to facilitate and accommodate existing external cardiac compressors as well as accommodating manual preliminary cardiopulmonary resuscitation.
II. Description of the Prior Art
Existing mechanical cardiac compressors have been extremely successful in treating patients in various phases of cardiac arrests. Such a cardiac compressor is illustrated in FIGS. 1 and 2 of the drawings and briefly, includes a support platform 12 positionable beneath the patient's back. Preferably, the lower sternum of the patient is centered over the platform so that it provides full support for operation of the compressor system. A compressor sub-assembly 16 includes a post 18 and base attachment 20 which is preferably detachable from platform 12 so that the latter can be inserted beneath the patient prior to mounting the compressor sub-assembly thereon. This, of course, facilitates positioning the platform under various types of patients.
FIGS. 5 and 6 illustrate in part a combination cardiac compressor and pulmonary ventilation system 10a illustrated in fully assembled operative fashion in FIG. 6. Such a system is similar to the compressor illustrated in FIGS. 1 and 2 and like reference numerals are utilized to illustrate similar parts with the suffix a. The system 10a of course is designed to provide pulmonary ventilation in addition to resuscitation. A quick disconnect plate bar 22 is shown in FIG. 5 with an actuating handle 24 manipulative to disconnect sub-assembly 16a or conversely provide quick attachment thereto. External cardiac compressors and combination pulmonary ventilation systems of the type illustrated in the drawings are illustrated and described in detail in Applicant's prior issued, commonly assigned U.S. Pat. No. 3,364,924 entitled PNEUMATICALLY OPERATED CLOSED CHEST CARDIAC COMPRESSOR dated Jan. 23, 1968; U.S. Pat. No. 3,364,925 entitled EXTERNAL CARDIAC COMPRESSOR likewise date Jan. 23, 1968; and U.S. Pat. No. 3,461,860 entitled PULMONARY VENTILATION SYSTEM AND COMBINATION CARDIAC COMPRESSOR AND VENTILATION SYSTEM dated Aug. 19, 1969.
There is a growing recognition of the need for and the importance of mechanical cardiopulmonary resuscitative support for the cardiac arrest patient in certain environments. One of these environments is the patient in ambulance transport. In the standard ambulance, a cardiopulmonary resuscitator (CPR) is the only practical approach available for dealing with cardiac arrests. In the fully sophisticated "Cardiac Vans", it is frequency needed for: (1) refractory cardiac arrest patients, who are non-responsive to the early attempts at definitive therapy, and (2) patients who have been in cardiac arrests for over one minute without support, and who will frequently require extended supportive therapy to improve myocardial tone before definitive therapy in the form of drugs and electrical defibrillation, can be successful. In such cases, there is a frequent need to maintain the highest possible levels of CPR support with the patient in transport.
CPR's of the type described above are ideally suited for this purpose as they were specifically designed for ambulance application, and are being widely and very successfully utilized. While in certain instances a support platform 12 such as that referred to in FIG. 1 is both feasible and practical for the patient in transit under CPR support on a standard ambulance cot without any restraints or auxiliary equipment whatsoever, there are situations where a system of restraint for the cardiac compressor-patient-cot system can be very helpful. These situations would include: (1) instances where mechanical CPR support would be started with the patient on an ambulance cot remote from the ambulance and where return of the cot with the patient involves more than rolling the cot back over relatively smooth terrain--e.g. down or up stairways, or over rough terrain, or in congested situations; and (2) instances where the subsequent travel of the ambulance is over unusually rough terrain, or over tortuous roadway. Ideally, such a restraint system should meet the following specifications: (1) the restraint system should tie all three elements of the system--mechanical compressor, patient and cot--together, one hundred percent of the time, as an integral system, sufficient to inhibit significant relative motion between any two parts of the system. The restraint should be adequate for plus or minus one gravitational force of lateral accelleration which is equivalent to a 45.degree. tilt of the ambulance cot; (2) the restraint provided to meet (1) above must not restrict the patient's chest in any way. Normal chest spring-back following each compression cycle, and normal chest rise during each ventilation cycle must remain completely uninhibited; (3) the restraint system must be quickly and easily applied, covering a wide range of patient sizes, pediatric to very large patients; (4) the restraint system must in no way detract from the normal speed and/or ease of applying the CPR to a patient, and must permit its application from either the right or left side of the patient; and (5) the restraint system should be usable with preliminary manual CPR--providing good back support and head extensions for the manual technique even before the mechanical equipment is applied. Easy access for introduction of the mechanical equipment must thus be provided without having to remove the patient from the support while the mechanical CPR is brought into position for utilization.
Applicant is unaware of any prior art designed to accomplish the foregoing objectives. Heretofore, it has not been thought to provide a support device beneath the patient which permitted insertion of a CPR platform without moving the patient. Basically, the only retention system utilized was that of a strap on either the ambulance stretcher or cot. However, none of the prior art approaches met the needs specified above, and thus there is a genuine need in this art for an improved patient support and retention system.